Presented by Chloe Ruebeck University of Utah May 05, 2009. High Incidence Condition Presentation: Anxiety Disorders. Training School Psychologists to be Experts in Evidence Based Practice for Tertiary Students with Serious Emotional Disturbance/Behavioral Disorders

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A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).

B. The person finds it difficult to control the worry.

C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months). Note: Only one of the following items is required in children.

D. The focus of the anxiety and worry is not confined to features of an Axis I disorder.

E. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

F. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism) and does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or a Pervasive Developmental Disorder.

There are three considerations that should be taken into account when diagnosing. First, is the anxiety produced by an actual threat, then the youth’s developmental context, and lastly the degree of impairment.

There are two types of anxieties, state and trait. State anxiety can occur in certain situations and trait anxiety is more stable occurring across situations (Cattell & Schier, 1961, 1963)

Anxiety can cause significant school problems for children both academically and socially (Ginsburg & Silverman, 1996)

According to Gray’s Model, the Behavioral Inhibition System (BIS) causes anxiety. Anxiety symptoms occur when the Comparator subsystem of the BIS predicts an aversive or unmatching future event (1982).

Many of these aversive ideas come from individuals’ schemas. These schemas are usually established early in development. A number of theories for this acquisition are; “preparedness” (Seligman, 1970,1971), two-factor theory (Mowrer, 1939), approach-withdrawal theory (Delprato & McGlynn, 1984) and social learning theory (Bandura, 1977).

Some of the causes of these negative schemas are academic performance, situational variables in the family or at school, stress and pressure, perceived or real expectations by self or others, and degree of success in social and academic situations (Huberty, 45-52).

Genetics also plays a role in anxious youth. Children of anxiety disordered mothers are more likely to have anxiety. Another factor that contributes to this, is modeling (Last, Hersen, Kazdin, Francis, & Grubb, 1987).

The remaining 8-12 sessions focus on tailoring coping plan’s for each child’s fears and anxieties, while implementing modeling, in vivo exposures, role plays, relaxation training, and contingent reinforcement

The Revised Children's Manifest Anxiety Scales (RCMAS) was used as the dependent measure along with a battery of other scales and interviews, children were given these scales at pre and post test

Parents and teachers were also asked to report anxiety symptoms using the CBCL

The parents reported that 71% of the children no longer had their primary anxiety disorder as their primary disorder and 51% no longer met criteria for their primary anxiety disorder at post-treatment (Kendall et. al., 1997).

A number of treatments have shown to be efficacious in reducing and treating anxiety related symptoms, moreover, a combination of interventions may be the most effective in treating children with anxiety disorder.

Eisenberg, Cumberland, and Spinrad (1998), suggest that getting the parents involved in treatment and encouraging them to talk to their children, accept them and be supportive could help improve their emotional competence.

Bird, H.R., Gould, M.S., & Staghezza, B. M. (1993). Patterns of diagnostic comorbidity in a community sample of children aged 9 through 16 years. Journal of the American Academy of Child and Adolescent Psychiatry, 42 (4), 415-423.